A sharp, throbbing, or constant ache in a tooth often signals a problem with the innermost layer, the pulp. This soft tissue contains the tooth’s nerves and blood vessels. When the nerve is exposed, infected, or severely irritated, the resulting discomfort requires professional attention. While temporary measures can manage acute pain, a lasting solution depends entirely on treating the underlying cause.
Immediate Relief Measures You Can Take at Home
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often the first line of defense against tooth nerve pain. These medications work systemically by reducing the inflammation that causes pressure and pain within the tooth’s rigid structure. Following the dosage instructions on the packaging can help manage the pain temporarily until a dental appointment can be secured.
Applying a cold compress to the outside of the cheek near the painful area can also provide immediate, localized relief. The cold temperature constricts the blood vessels, which helps to reduce swelling and temporarily numb the nerve signals. You should apply the cold compress wrapped in a cloth for about 15 to 20 minutes at a time, repeating the process every few hours as necessary.
Rinsing the mouth with warm salt water can help cleanse the area and reduce local irritation. Salt acts as a natural antiseptic and can draw fluid out of swollen tissues, helping to minimize inflammation. Dissolving half a teaspoon of salt in a cup of warm water and gently swishing the solution for about 30 seconds helps to clean away debris and soothe the surrounding gums.
For a more targeted topical treatment, clove oil contains a compound called eugenol, which is a natural anesthetic and anti-inflammatory agent. Diluting a small amount of clove oil with a carrier oil like olive oil and dabbing it carefully onto the affected area with a cotton swab can temporarily numb the pain. This should be used sparingly and only as a stopgap, as it does not address the source of the problem.
Understanding the Source of Nerve Pain
Severe tooth nerve pain is primarily caused by pulpitis, the inflammation of the dental pulp. The most common trigger is deep tooth decay, where bacteria erode the enamel and dentin layers, eventually reaching and infecting the pulp tissue. Once bacteria enter this innermost chamber, the resulting infection causes swelling and pressure, leading to characteristic throbbing pain.
Physical damage to the tooth structure also creates pathways for bacteria to enter, leading to nerve irritation. A cracked tooth, even with a hairline fracture, can allow hot or cold stimuli and oral bacteria to penetrate deep enough to affect the pulp. Trauma from an impact or injury can also directly damage the nerve and blood vessels inside the tooth, often leading to a painful or dying pulp.
Gum recession, which can be caused by aggressive brushing or periodontal disease, can expose the sensitive root surface, known as dentin. While dentin exposure often causes sharp sensitivity to temperature, severe recession can sometimes contribute to pulp irritation over time. In all cases, the inflammation signifies that the protective outer layers of the tooth have been compromised, leaving the nerve vulnerable.
When Emergency Dental Care is Necessary
Certain symptoms accompanying tooth nerve pain signal a severe infection that requires immediate intervention. Swelling that extends beyond the gum line and affects the cheek, jaw, or neck indicates the infection is spreading rapidly and could potentially block the airway. Immediate care from an emergency dentist or hospital emergency room is necessary if you experience any of the following:
- A fever, particularly one above 101°F, paired with dental pain.
- Pain that is intense, constant, and does not respond to over-the-counter medication.
- Difficulty swallowing or breathing, indicating swelling near the throat.
- Visible pus, a foul taste in the mouth, or a sudden change in bite, signaling an advanced dental abscess.
Professional Solutions for Lasting Relief
Definitive treatment for tooth nerve pain depends entirely on the degree of damage and whether the pulpitis is reversible. If the decay or crack is shallow and has only caused mild, short-lived sensitivity, a simple filling or crown can be placed. This procedure removes the damaged area and seals the tooth, allowing the mildly irritated nerve to recover and the symptoms to resolve.
When the nerve damage is irreversible, or the pulp tissue has become necrotic, a procedure called root canal therapy is performed to save the tooth. The dentist accesses the inner chamber, removes the infected pulp, cleans and disinfects the entire canal system, and then seals the empty space. This eliminates the source of the infection and the pain, allowing the tooth to remain functional.
Following a root canal, a dental crown is often placed over the tooth, especially on back teeth, to restore its strength and prevent future fractures. This restoration is necessary because the root canal procedure and the preceding decay often remove a significant amount of the tooth’s structure, making it brittle. Extraction, or removing the entire tooth, is considered a last resort when the tooth is fractured too severely or cannot be restored by any other means.